Out-of-the-Ordinary-Experiences (OOEs) and Psychosis (1/2): swimming against the current

A particularly shocking demonstration of the limitations of the genetic argument is an epidemiological analysis of the prevalence and incidence of schizophrenia in Nazi Germany, wherein it is estimated between 220,000 and 269,500 citizens with the diagnosis were forcibly sterilized or murdered by the Nazi regime (Read & Masson, 2013; Torrey & Yolken, 2010). Contrary to everything that is known about genetic, heritable conditions, the rates of schizophrenia diagnoses in Germany did not diminish after the war but increased. The analysis showed this atrocity provided proof against the very reasoning used to instigate it.

(The Role of Social Adversity in the Etiology of Psychosis by
Eleanor Longden and John Read – page 11)

Some time ago on this blog I addressed the issue of neuroplasticity. I shared my frustration at how the neuroscientific community’s resistance to the idea that the mature brain could change had been a damaging doctrine for decades.

As I wrote in 2012, even if you only date the start of a belief in neuroplasticity at 1962 – and there is some evidence it could fairly be backdated earlier than that – 34 years seems a long time to wait for such a clinically vital concept to surface into general practice.

I can testify to that from personal experience. From when I first studied psychology in 1975 until I qualified as a clinical psychologist in 1982, the conventional wisdom was that the adult brain had virtually no capacity to change itself. I cannot exactly remember when it became respectable to doubt that dogma, but I am fairly sure it was well into the 90s. And even then it was a qualified scepticism only. We were into the new century before I became aware of the wide-ranging and radical possibilities that people like Schwartz have written about.

It is horrifying to contemplate the human cost of such resolute intransigence in the face of compelling data.

I have expressed equal frustration, if not more, at the obdurate dogmatism with which mainstream materialistic science denies validity to spiritual experiences of almost any kind.

Not even once in my entire experience of being taught psychology did I ever hear of Frederick William Henry Myers, a resolute explorer of the borderland between mind and spirit. The closest encounter I ever had of this kind was with William James. He was mentioned in asides with a dismissive and grudging kind of respect. The implication was that he was an amazing thinker for his time but nowadays very much old hat. I gave him a quick glance and moved on.

Looking back now I realise I was robbed.

Kelly and Kelly capture it neatly and clearly in the introduction to their brave, thorough and well-researched book, Irreducible Mind (pages xvii-xviii):

[William] James’s person-centered and synoptic approach was soon largely abandoned . . . in favour of a much narrower conception of scientific psychology. Deeply rooted in earlier 19th-century thought, this approach advocated deliberate emulation of the presuppositions and methods – and thus, it was hoped, the stunning success – of the “hard” sciences especially physics. . . . Psychology was no longer to be the science of mental life, as James had defined it. Rather it was to be the science of behaviour, “a purely objective experimental branch of natural science”. It should “never use the terms consciousness, mental states, mind, content, introspectively verifiable, imagery, and the like.”

And, sadly, in some senses nothing much has changed. Too many psychologists are still, for the most part, pursuing the Holy Grail of a complete materialistic explanation for every aspect of consciousness and the working of the mind.

I have a comparable, perhaps even greater, sense of frustration about a similarly destructive dogmatism that bedevils the clinical/psychiatric approach to so-called psychotic experiences. This is far more damaging, for reasons that will become clear in a moment, than the a priori rubbishing of psi or near death experiences, unhealthy as that undoubtedly is.

My recent decluttering process triggered the feeling all over again. I’ve been sorting through back issues of my psychology journals. In the process, I found one article of particular interest on this theme. Sadly it was the only one I found in the dozens of journals I have checked through for items of interest before deciding whether to discard them. (As I later discovered through trawling the web and my British Psychological Society website in particular, there are others sailing against the hitherto prevailing current of dogmatic biodeterminism, but they are still the exception rather than the rule. The BPS as a body, to its credit, is getting on board as well, as quotes I use in later posts will testify.)

The journal[1] was dated 2012 and contained a paper by Charles Heriot-Maitland, Matthew Knight and Emmanuelle Peters on the subject of what they call Out-of-the-Ordinary-Experiences or OOEs. The focus of the study was to use a phenomenological interview process that enabled them to compare the experiences of two small groups of people, one group who had been diagnosed as psychotic, labelled the clinical (C) group, and other who had not, labelled the non-clinical (NC) group.

Their operating assumption from the start was that voice-hearing prevalence, which runs at 10-15%, (page 38) ‘suggests that OOEs do not inevitably lead to psychiatric conditions, and that people can experience psychotic-like phenomena whilst continuing to function effectively.’

They also refer to two other pieces of research from this sparsely populated field of investigation.

First of all, they quote Brett et al (2007) as finding that ‘while [their Diagnosed] group were more likely to appraise their experiences as external and caused by other people, the [Undiagnosed] group made more psychological, spiritual and normalising appraisals, and reported higher perceived understanding from others. . . . . They . . . did find trauma levels in both groups to be higher than in the general population.’

Jackson and Fulford (1997), which they describe as the only known published qualitative study of clinical and nonclinical populations with OOEs, also found that psychotic-like experiences were triggered in both groups by intense stress in the context of existential crises, and that the subsequent group distinction depended on ‘the way in which psychotic phenomena are embedded in the values and beliefs of the person concerned.’

Later work has expanded on this. For instance, Eleanor Longden and John Read in their review of the evidence concerning the role of social adversity in the etiology of psychosis (American Journal of Psychotherapy, Vol. 70, No. 1, 2016: pages 21-22) summarise a wealth of data that suggests that, not only is trauma a clear factor in the incidence of psychosis, but also psychotic experiences relate strongly to the nature of the trauma experienced. For example, work with 41 patients experiencing a first episode of psychosis found that attributes of stressful events in the year preceding psychosis onset were significantly associated with core themes of both delusions and hallucinations (Raune, Bebbington, Dunn, & Kuipers, 2006).

Where the OOE work is particularly significant is in the emphasis it places on the potentially positive function of the psychotic experience in and of itself, a rare perspective indeed. Even a paper on the existential approach (Grant S Shields – Existential Analysis 25.1: January 2014 – page 143) takes a somewhat darker view of such experiences, seeing psychosis as ‘a mechanism for coping with existential distress – a way of being that allows an individual to escape existential realities when that individual cannot avoid these things otherwise.’ I will be returning to a more detailed consideration of his valuable but different position in a later post.

Later in this sequence I will refer back to other thinking and data that expand on the relationship between levels of consciousness or understanding, and the stress caused by experiences that challenge the models of reality we have so far developed. I’ll just focus in the reminder of this first post in the sequence on the basics of what this study found (pages 41-49). Please bear in mind as you read that we should do our best to see the experiences labelled ‘psychotic’ not as some alien state remote from anything we might ever have to undergo ourselves, but as simply part of a continuum, a dimension, along which we all are placed and therefore could at some point also be thrust to a similar extreme, given the wrong circumstances. I’ll be retiring to they theme in a later sequence as well.

Nearly all participants in both groups reported a period of emotional suffering before their first OOE. There was a sense, therefore, that the first OOE was a direct expression of emotional concerns at the time. For details of what some of the OOEs were like, see the table above.

A process of existential questioning came into the mix. Similar to the emotional suffering, there also seemed to be some direct relevance of OOEs to the context of participants’ existential questioning. From this, it could be interpreted that the OOE actually emerged as a direct expression of, or indeed solution to, some kind of psychological crisis.

Isolation, which was reported equally across both groups, was either caused by intentional social withdrawal, or by private pre-occupation with other activities. It may therefore be that isolation has more of a causal role in triggering the experience itself, perhaps because it encourages introspective focus on the kinds of emotional and/or existential concerns mentioned above.

At first I thought the authors might be operating on an implicit assumption that isolation is generally undesirable, but revised that view in the light of the paper as a whole.

One of their most striking findings was the powerful language used by participants to describe the emotionally fulfilling and euphoric qualities of their experiences.

Next Monday I’ll be looking more directly at the spiritual implications of this.